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Me Talk Pretty – Syndromes

Hello party people! I know it’s been many moons since I’ve posted an article but hey, let’s not dwell on the past. It’s bad for your complexion. In this episode of Me Talk Pretty I would like to introduce a topic that has wandered the deserts of obscurity for eons in need of clarity, and today we’re gonna make it rain. For many of us, the definition of a syndrome is as elusive as the lyrics to Tiny Dancer (hold me closer Tony Danza..I’m cold). Let’s clear a few things up shall we.

Syndrome versus Disease…FIGHT!

The classifications for diseases and syndromes are so closely related that they could be wearing the same underwear (like 100% cotton with no room to breath). There is a somewhat reliable consensus that a disease is classified as – having recognizable signs and symptoms which have a consistent anatomical or physiological effect on the body and are linked to a KNOWN CAUSE, a.ka etiologic agent. For example, Bacterial Meningitis is the inflammation of the protective layer of the brain in response to some nasty ole bacterial infection in the blood stream.

A) This disease has a known cause – playa hating bacterial infection by the bacteria Neisseria meningitidis (or any number of known pathogens)

B) This disease has a recognizable physiological effect on an organ/organ system – inflammatory response within the meninges of the brain and infiltration of cerebrospinal fluid leading to systemic central nervous system infection.

I would like to tell you that a syndrome is distinguishable from a disease by – having recognizable signs and symptoms which have a consistent anatomical or physiological effect on the body but have NO KNOWN CAUSE. However, we know that Acquired Immunodeficiency Syndrome (AIDS) is linked to an infection with HIV (Human immunodeficiency virus) which attacks our CD4 T-cells. AIDS is classified as a syndrome because the condition has such a broad spectrum of symptoms and complications resulting from the breakdown of the immune system that it can not be classified as a single disease process. On the other hand, Carpal Tunnel Syndrome (the chronic pain and impaired functionality of the hand and wrist associated with the constriction of the medial nerve of the wrist) has a consistent pattern of symptoms and physiological effects BUT the causes of carpal tunnel are highly debatable.

So I would like to be so bold as to say that as a general rule of thumb – what makes a syndrome a syndrome is in the complicated nature of identifying a single, consistent cause for a pattern of signs and symptoms that typically appear together.

I know I know…this one is a little messy. So let’s think of it abstractly.

One afternoon I walk outside and notice that everyone is wearing bright green t-shirts, and walking in groups along the sidewalks with four leaf clovers painted on their faces, carrying mugs of bubbly green liquid. As I walk past restaurants I see lunch specials for corned beef and cabbage. Based on these signs and symptoms I immediately check the calendar (March 17th) and quickly diagnose the phenomenon as St. Patrick’s day. It has been well established that these patterns of behavior only occur together on this particular day. So based on what I’ve told you, would you classify this holiday as a disease or a syndrome?

How about this one – One afternoon I walk outside and there’s a parking ticket on my windshield. Later that day I crack the screen to my smart phone and can no longer make calls which causes me to miss a crucial text message about a party that night. Based on these signs and symptoms I immediately look at the calendar (Friday 13th) and I quickly diagnose the phenomenon as Bad luck. The association of these patterns of behavior are both poorly understood and highly debatable. If bad luck were an illness would you classify it as a disease or a syndrome? (yeah I know that’s a lousy example but humor me)

Truthfully, science and medicine have a rich history of naming things based on an original misconception. Long after the true mechanism and process is recognized and established we will hold on to that misnomer with the rabid tenacity of a ravenous pitbull…that’s people for you.
Air is the miraculous, serendipitous casualty of photosynthetic metabolism

Just had to follow-up on your question “If bad luck were an illness would you classify it as a disease or a syndrome?” Based on the definitions that you give for “disease” versus “syndrome” I would have to say that bad luck (in this case) is a syndrome, but ONLY because a direct cause has not been identified. The absense of evidence is not the evidence of absense. Of course… if you just admit that you woke up on the wrong side of the bed, we can call this a disease and be done with it. :o)